HomeMy WebLinkAboutBLD2006-01323 Final SFR - BLD Permit / Conditions - 7/26/2007 Inspection Line(36 0)4 27-726 2
MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352
Mason County Bldg. III 426 W. Cedar P.O. Box 186
Shelton,WA 98584
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RESIDENTIAL BUILDING PERMIT BLD2006-01323
OWNER: TRACI SPURLOCK
CONTRACTOR: ADAIR HOMES INC (360)352-8571 LICENSE:ADAIRH*262RZ EXP: 1/9/2007 RECEIVED: 7/25/2006
SITE ADDRESS: 595 NE TAHUYA RIVER RD TAHUYA ISSUED: 10/3/2006
PARCEL NUMBER: 322127590010 EXPIRES: 4/3/2007
LEGAL DESCRIPTION: TR 1 EX OF SURVEY 1/138 NW1/4 LOT: 1 OF SP#628
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
NEW SFR BELFAIR TAHUYA TO TAHUYA RIVER . SITE ON LEFT OF TAHUYA RIVER
STOCK#2003-0050 ROAD JUST BEFORE 651 TAHUYA RIVER. 100 FEET DOWN DRIVE ON RT.
FLAGGED AND SIGN AT BOTH ENTRACE AND SITE.
General Information Construction &Occupancy Information Square Footage Information
No.of Bedrooms: 3 Type of Constr.:
Type of Use: SF Insp.Area: No. of Bathrooms: 3 Occ. Group: Lot Size: Deck:
Type of Work: NEW Fire Dist.: 8 No. of Stories: 2 Occ. Load: Building:2,080 Garage-Attached 440
Valuation: Building Height: 23 Occ. Status: Primary Basement: COVPORCH 240
Manufactured Home Information Setback Information Shoreline&Planning Information
Make: Length: Ft. Front: W 182.0 Ft. Shoreline: Ft. Water Body: NONE
Rear: E 640.0 Ft. Slope: Ft. SEPA?: No
Model: Width: Ft. Shoreline Desig.: Not Applicable Side 1: N 181.0 Ft. pp'cable
Year: Serial No.: Side 2: S 60.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Dishwasher 1 Exhaust Hood 1 Planning Review Fee KS 7/25/2006 $155.00 S12006000
Hosebibs 3 Ventilation Fan 4 Plan Check Fee KS 7/25/2006 $253.63 512006000
Kitchen Sink 1 Dryer Vent 1 Building Permit Fee KS 7/25/2006 $4.48 522006000
Lavatories 4 Address Fee GMM 8/3/2006 $140.00 S22006000
Showers 2 Building State Fee ARC 8/8/2006 $4.50 S22006000
Water Closets (Toilets) 4 Building Permit Fee ARC 8/8/2006 $1,290.55 S22006000
Water Heaters 1 Mechanical Fee ARC 8/8/2006 $46.90 522006000
Bath Tubs 1 Mechanical Base Fee ARC 8/8/2006 $23.50 S22006000
Clothes Washer 1 Plumbing Fee ARC 8/8/2006 $11o.0o $22006000
Plumbing Base Fee ARC 8/8/2006 $20.00 S22006000
EH Plan Review TW 9/15/2006 $75.00 522006000
Total $2,123.56
BLD2006-01323 Please referto the following pages for conditions of this permit. 1 of 5
CASE NOTES FOR
BLD2006-01323
CONDITIONS FOR
BLD2006-01323
1) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division.
There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at
1-800-647-0982 The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
X �;/
2) Water qua lit)
Vt to be degraded to the detriment of the aquatic environment as a result of this project.
X
3) Prior to final approval, all upland areas disturbed or newly cre ted by construction activities shall be seeded, vegetated or given an equivalent type of
erosion protection (silt fencing or straw matting). X
4) Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
X
5) By definition, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your"Approved Site Plan"to ensure
these structures meet the setback conditions listed.
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6) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your
"Approved Site P "to ensure these structures are shown and meet the setback conditions listed.
X
7) A Road Access Permit or Approval must be granted by the Mason County Department of Public Works. For more information contact Public Works, at
(360)427-9670, ext. 450. The building permit will not be"finaled" until the permit holder can show proof that the access permit from Public Works has
been "finaled" d approved.
X
8) The international code requires a fire apparatus access road for every facility, building, or portion of a building that is more than 150'from an approved
access road. Roads are required to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where
such roads co with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road.
X
BLD2006-01323 Please refer to the following pages for conditions of this permit. 2 of 5
�) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and plans are not available on site, then approval will
not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and must be collected by the Building
Department pn rr any further inspections being performed or approvals granted.
Xj(
10) In accordance with international codes and Title 14, Mason County Building Code, "Standards for Fire Apparatus Access Roads,"all new structures that
require an address shall have approved numbers or addresses located at the beginning of long driveways when the address is not clearly visible from the
access road. The numbers shall also be plainly visible and legible from the street or road fronting the property and shall contrast with their background.
Mason County Building Department requires that this be completed prior to calling for any site inspections. A re-inspection fee based on rates as adopted
by the jurisdiction and the international codes will be assessed if the owner and/or contractor fail to post the address on site prior to requesting
inspections.
X
11) The plan review check list and corrections are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the
corrections indicated on the plans. Once the plans are marked "APPROVED", they shall not be changed or altered without authorization from the Building
Official. The permit holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or
removal of ap ro ed documents will result in failure of required building inspections.
X
12) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X r5�I
13) The"approved" site plan is required to be on-site for inspection purposes. If an inspection is requested and the"approved" site plan is not on site, then
approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the
Building Depa`tn prior to any further inspections being performed or approvals granted.
X
14) Washington State Energy Code Compliance has been approved using the following:
Heat Type: Electric or other fuels, Compliance Method: IV, Window(Max U-Factor):0.40, Skylight (Max U-Factor):0.58,
Doors (Typ%U-Factor):0.40 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation R-38, Vault Insulation R-30, Slab Insulation R-10.
X
15) Per 2003 IRC -SECTION 1609 -WIND LOADS - 1609.1 Applications. Buildings, structures and parts thereof shall be designed to withstand the
minimum wind loads prescribed herein. Decreases in wind load shall not be made for the effect of shielding by other structures. Per FIGURE 1609
BASIC WIND PEED (3-SECOND GUST)the wind speed for Mason County is 85 MPH.
X
16) Per 2003 IRC - SECTION R905- REQUIREMENTS FOR ROOF COVERINGS- R905.1 Roof covering application. Roof coverings shall be applied in
accordance the applicable provisions of this section and the manufacturer's installation instructions.
X_
BLD2006-01323 Please referto the following pages for conditions of this permit. 3 of 5
17) Stock Plan Identification number: 2003-0050
This project is approved subject to the provisions identified the Mason County Stock Plan Policy. The site plan approved by the Planning Department,
` original building plans, and all attachments 9 p approved by the Mason County Building Department shall be available for the Mason County Building
a
Inspector t a re
quired inspection.
X
18) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other
vertical concrete work exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2).
X ;�o
19) All construction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the
State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in
permit revo ti n.
X
20) Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUST NOT adversely impact
adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either private ditches and drains will meet requirements of the
stormwater ordinance or prior approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose. For further
information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access
connecting from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which
is proposed to be located within 25' of a Mason County road right of way, it is suggested to contact that office to review future planned work which may
affect your project.) `
21) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordinance or regulation, must be reviewed and approved by Mason County prior to construction.
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22) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED
BUILDING CODE.
The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance
with the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building
Inspector shale made prior to requesting additional inspections.
X
23) All property lines shall be clearly identified at the time of foundation inspection. X (7tz/
24) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure
to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with
Mason Countyo ginances and building regulations.
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BLD2006-01323 Please referto the following pages for conditions of this permit. 4 of 5
25) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for
= action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit
holder have prevented action from being taken. No more than one extension may be granted.
' X /
26) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
connectors /flashing. Install metal connectors approved for contact with the new types of pressure treated material.
X
27) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered. X
28) This parcel isjoicated in a smoke management zone. Please contact a fire warden at (360)427-9670 ext. 459 for further information.
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This permit becomes null and void if work or construction authorized is not commenced within 180 days,or if construction or work is suspended for a period of 180 days at any time after work is
commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of
work is by means of a progress inspection.The owner or the agent on the owners behalf,represents that the information provided is accurate and grants employees of Mason County access to
the above described property and structure for review nd inspection.
OWN ER OR AGENT: 7kztal DATE:
BLD2006-01323 Please refer to the following pages for conditions of this permit. 5 of 5
Cf)
N CONCRETE MECHANICAL MANUFACTURED HOME M
0
rn Footings /Setbacks Date By Gas
o Gas Piping
Interior Date �a 6 ' By��S interior-Date By Date 19 r
Exterior Date Zl Y °
w BY Exterior-Rake B n
Set-up
INSULATION
Point Load/Isolated Footings Date Ely
BG 1 SLAB INSULATION T
Rate BY Data By FIRE DEPARTMENT s
Foundati Wa11s Floors Data By
Date i2, �`(P ByR� Data By DEC
FRAMI G Walls Date D 06 B
Date By Data By PROPANE TANKS
PLUMBING vault Date By
Date By OTHER
Groundwork
Attic
Type-
Date BY ate By Date By
D.W.V DRYWALLType:
Date
Int Brace Wall Date By
By W
�,
Date By22MFINAL INSPECinoN p
Water Line Fire Separation No
Date By Date By Date BY O
m to
Pass or Request Inspect. b
° Type of Insp. Fail Date Date Done By Comments N
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PLOT PLAN
Name / /�/9 s �CCL
Mailing Address /t2� olw_ �/i�4IL el �'� ,�4A , 9915a8
Home # 3&o-a77-07f1 5 _Work # Cell # 3W, ---71 U-- 13 30
Property Location XXK h LP ��l vet o'iej -7"q a U " ,tAJA,
Legal Address TS ,XR 3W 5ec b� Tax Lot # 3aa Ia 75 910o/6
County, State of 6L)ASHVIL) 7-01U
THE INFORMATION ON THIS PLOT PLAN HAS BEEN PROVIDED AND REVIEWED BY THE PROPERTY
VV;'ll1 OWNER WHO BY SIGNING BELOW.1)ACKNOWLEDGES AND ACCEPTS FULL RESPONSIBILITY
a y� FOR ITS ACCURACY AND COMPLETENESS,2)I5 RE5PONSIBLE TO ENSURE THAT THE
IMPROVEMENTS TO THE SITE TAKE PLACE IN CONFORMANCE WITH THIS PLAN:3)WILL
^I ESTABLI5H ALL THE CORNER IRONS,LOT LINES AND CODE-REQUIRED SETBACKS REQUIRED OF _.
F.0 L A15C r1[Y)T THIS PROPERTY.ANY CHANGE(5)TO THIS PLAN MUST BE PRE-APPROVED BY THE
E Lo GOVERNMENTAL AGENCIES WITH JL)RISDICTION.THE MORTGAGE LENDER AND THE
l7 CONTRA TOR
RAAND
�DOCUMENTEDA G
L10'2 O d
4 / OWNER SIGNATURE TE
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OWNER SIGNATURE DATE
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CC�P�
Request To Revise An Approved PI
pn an
Permit Number: BLD200 . _ Name It.a c ��,k
Parcel Number -tea 1 ) f 5 �.��
-5 - t0 L" Phone Number da ime Project Address .S T� h ��.�
Please provide a complete,detailed description of the revisions to the approved plans: .
DInc w t2C ,\.I 0tz proposed
Are two sets of the revised plans or addendum indicating the changes included? ❑ Yes
Are the approved site plans included? No
Are the revisions clearly and accurately identified on the plans or addendum? yes Yes ❑ No
Does the plan contain an engineer's or architect's lateral or vertical analysis? ❑ Yes ❑ No
If Yes,Has the engineer or architect No
improved this revision?
approval included
Is a stamped and signed ❑ _Yes ,❑ No
with this request? ❑ Yes
ote:No structural changes to a"desi ed"Plan will be a *No
ved without the written consent of the enerincer and/or architect of record.
Does the proposed revision modify the footprint or location of the structure? ❑ Yes
If Yes, Is a revised site plan,,with all new setback dimensions included with this request?XNO
Additional Information: ❑ Yes ❑ No
Applicant's signature Date: 3 U
office Use Only f _
Reooived
Date Sent Assigned To Approved By Date
B• 0�3 Q jJ n ,o Original Valuation
300 Additional Valuation:
Sq.Ft. x _.
Sq.Ft. x $
Total New Valuation S
Additional Fees:
Additional Planning Dept. S
NOW Setbacks: Front _Rear Additional Plan Review s o0
/ Additional Building Permit $
Side1 / Side2 / Additional Plumbing $
Additional Conditions/Comments: Additional Mechanical $
Additional E.H.Dept. $
Other $
Total Amount Due: $
Amount To Be Paid Up-Front$
raa b;a,i
Rftisea swc venom
Guard installed on all decks over 3V above arade.
The greatest riser and the greatest stair 7wed
pacing Vertical Pickets at handrail tread shall not exceed the en pickets.
smallest by more than 318." _
Graspable handraWon
all stailrvays.vdth 4 or
more risers.
Not less than 34"and
not more-than 38" fi
vertically from nose of I+;
tread or walking surface.
Min.Guard
t Y Height
� 36"
Handrail ends shall rt t
be returned or shall I
terminate in newell
posts or safety
terminals. t
.� t.
�I r
10"min. .; ( Indicate ioist size/saacina s Ledger at wall:
Stair nosing.not less than Decks shall be
3/4"but not more than ® positively anchored
1-114"on all solid risers Indicate beam for lateral&vertical
unless tread depth is at 7 314 loads. Toenails or
size/spacing.Provide y nails sub
least 11' max. 35 positive connection post withdrawal are ct onot
allowed.Decks shall
E;t be self supporting if
Indicate fasteners r Indeate ` Indicate post size,spacing connections cannot
stringer size. t. and base connector. be verified during
y Spade per inspection.R502.2
decking material
4"x4"x16"masonry
block with asphalt 12 ' I
shim.
Decks installed against manufactured
Provide 4."wood/earth clearance here, - homes must have beam support at this
6"all.Pth(W areas. location.
Concxete footing 12"helowgrade avhen deck is 30"or
more above grade.See foundation Info on reverse side. �rAU$71 $1-7
I Typical Door with 3 Risers CONSTRUCTION {�� ��,
rFate't irs;' ..PE�t.
MATERIALS lllumi s airs
Decay resistant woods with controls
Landings are required on heartwood of redwood,cedar, located at top and
each side of each black locust and pressure bottom of stairs.
exterior door. preservatively treated wood
Exception:A landing are all acceptable material for
is not required with use in deck construction. Field
two or fewer risers. applied treatment is not an
acceptable method. Fasteners min,
for pressure preservative
Landings shall not be treated woods shall be of hot- 4 36"min
van
more than top.of dipped galvanized steel, Ian����
lower Than the of stainless steel,silicon bronze 38 '------
top:
the threshold. or copper. Field cut ends,
Exception: notches and drilled holes of Min. 10"run
k ---The landing shall pressure preservatively treated
not be more than 7-3/4"lower wood shall be retreated in the
than the threshold provided the field in accordance with AWPA 36"min Max.7 3/4"rise
door does not swing over the landing. M4. landing
IRC R319&R320.
1) No
r
t�
off,
BA
G
be-
�� a.
3�
Ot- 34 s
��L�ST NIr�ET ALL CURRE"IT
STATE CODES 33
co
QED x I ► 6
APPROVED
w(tj
} A ,c BUILDING VAl ���ti � �� P
�.r,\- BUI TO APPRQ �� I y
CN�;y-ESSUBIECT S �30 ol THIllSEPL tiSrystlSr BE ,.
r
(3 ) D Zoolp - 5 /323
�Li r!l, 2 to c /-c
FI LE
b COPY
MUST MEET ALL CURRENT
WASHINGTON STATE CODES
CHANGES
SUBMIT CHANGES FOR APPROVAL
PRIOR TO PERFORMING WORK
T:lL:SE PLANS MUST BE
ON THE JOB SITE
FOR INSPECTION
�s
s/3c�
APPROVED
MASON BUILDING INSPECTOR
CHANGES SUBJECT TO APP OVA
C DATE 3 0 07
STRIP MAP
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Home Owner Information: I x iT
Customer: '7-kl9C- / S rOf 4 &k- v�
Address:A)F Qo Olklu- T/,5i,'I-
!.n S
Phone#: -�CoO-a'7'7 - 0795
3(D0- '710 - ) 33a
Site Address: p
Xxx ` ;G hu ycs n i VCR 61' i l�s
MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT
WSEC/VIAQ Compliance Application
Owner: GLC 1 lL Telephone: Z11_ Parcel#: Z 1S
Type of project ( New Residence ( )Addition ( ) Remodel
Total Sq. Ft. U 18 Floor : 2" floor: Heated Basement:
of heated area:: 0
Heating System: Aktiectric wall heater O Electric Central Furnace OLPG Furnace
O Heat Pump with Electric Furnace O Heat Pump vxith Gas Furnace O Boiler, specify fuel type
O Other: Specify:
Glazing Compliance Prescri tive O tion see reverse side circle one: 1 II V
Percentage: pllance
Method O Component Performance , Chapter 5— Calculation worksheets required
Check one::
O Systems analysis, Chapter 4
Whole House Ventilation system O Whole House Ventilation using a Heat
Ventilation using exhaust fans&window or wall fresh air
Recovery Ventilation System (VIAQ 303.4.4)
System vents (VIAQ 303.4.1)
Check one
O Whole House Ventilation Integrated O Whole House Ventilation using an inline
with a Forced Air System (VIAQ 303.4.2) su I fan. VIAQ 303.4.3)
Window & Door Schedule (If needed, attach an additional sheet)
Total
Manufacturer Roomllocation U-Factor Size Quantity Square Feet
Windows:
Windows: Total Sq. ft.
Doors:
Doors: Total Sq. Ft
Total window and door area
Total window 8�.door area /(divided by) total sq.ft of heated area = %of glazing
MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
Permit Assistance Center
SHELTON (360) 427-9670 BELFAIR (360)275-4467 SEATTLE (206)464-6968
ELMA(360)482-5269 FAx: (360) 427-7798 WEB SITE: www.co.mason.wa.us
P.O. Box 186, SHELTON 98584
2001 Washington State Energy Code (WSEC)
effective July 1, 2002
2000 Ventilation and Indoor Air Quality Code (VIAQ)
Code Compliance Application Form
The following information will be required for the WSEC and VIAQ plan review:
1. Complete the Washington State Energy Code/Ventilation and Indoor Air Quality Code
(WSEC/VIAQ)application located on the reverse side.
2. Complete the window and door schedule on the reverse side. Include all windows, skylights,
sliding glass doors, french doors and any door that is more than 50% glass. Use rough opening
dimensions of the windows and doors. Information about the U-factor of the window will also help
to expedite the energy code review. If you are complying with the WSEC by prescriptive path and
are using the area weighted average method you must include your calculations.
3. On your building plans note the location and fuel type of water heater, location of exhaust fans
(bathroom, laundry, kitchen, etc.) and R-factor of insulation proposed for walls, floors, ceilings and
slabs,
4. Questions? Call Mason County Community Development at (360) 427-9670 ext. 284. Additional
WSEC and VIAQ compliance information is available on the internet at:
www.energy.wsu.edu/buildings/
Prescriptive Requirements 0,1for Group R Occupancy
Climate Zone 1, Table 6-1
GlazingGlazing U-factor '
g Wall Wall Wall
Area%of ��°f Ceiling Vaulted Above interior° exterior Slab'
Option Floor vertical Overhead11 Factors 2 Ceiling3 Grade below 4 Below Floors on
10 12 grade Grade Grade
I 12% .35 .58 .20 R-38 R-30 R-15 R-15 R-10 R-30 R-10
II* 15%* .40 .58 .20 R-38 R-30 R-21 R-21 R-10 R-30 R-10
IV Unlimited
Single
Family Res .40 .58 .20 R-38 R-30 R-21 R-21 R-10 R-30 R-10
(R-3)Only
*Reference Case/Call (360)427-9670 ext.284 for footnote information. Log&solid timber wall with a min.avg.thickness of 3.5"are
exempt from the above grade wall insulation requirements.
OLYMPIA BRANCH ADAIR BUSINESS CENTER
2303 93rd Ave SW 1111 SW 170th Ave.
Olympia,WA 98512 Beaverton,OR 97006
Const.360-352-7641Eel Phone:503-645-4730
Sales 360-352-8571 Fax:503-645-9715
Fax 360-943-0701 It's a Smart Move.
July 17, 2006 RECEIVED
Mason County Bldg Dept. JUL 19 2006
Po Box 186 .MASON COUNTY
Shelton, WA 98584
Dear Official,
I am applying for the Building Permit application for Traci Spurlock, her site is located at
xxx Tuhuya River Road, Tahuya, WA 98588. I have included a check in the amount of
$408.63.
In this application I have included the water adequacy, plot plan, site plan and energy
form.
If you have any questions please contact me at (360) 352-8571.
Thank you,
t�tmt�1 0 41� 0c,
Sarah Reining
Admin Assistant
Adair/Olympia
OR CCB#593
WA#ADAIRH*262RZ
ADAIR HOMES,INC. AURORA BEND CALDWELL CRESWELL MEDFORD OLYMPIA WOODLAND
0
adairhomes.com " ''°
� MASON COUNTY PERMIT NO.
�'C�� BUILDING PERMIT APPLICATION
426 W. Cedar- P.O. Box 186, Shelton, WA 98584
Shelton (360) 427-9670 - Belfair(360) 275-4467 - Elma (360) 482-5269
On the web www.co.mason.wa.us
APPLICANT I FORMATION CONTRACTOR IN ORNJATION
Owner fi Y tQUC, Company Name Gll ,,-
Mailin AM, s Mailin ]Address-4_ IrC
State�_ Zip Code—
City ' City State �_Zip Code
Phone;�lw-Z-1'1-0��5 Other Ph.��(0.- t3 Phone — Other Ph. -
Lien/Title Holder Contractor Reg. # ,xp.
E mail address E Mail Address V 5-evCM
Drivers Lic.# DOB Drivers Lic.# DOB
SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic
Connect tgMlater System Name of Water System
Well Water System Name of Water System
PARCEL INFORMATION - 12 Di it Parcel No Fire District
Legal Description �'
Site Address(Pleas i lude street name treet number and city) WeX T4VY-A\(A . tVC, �fiTi1�(l[1 S� .
Directions to site
Will timber be cut and sold in parcel preparation? Yes/ o,
Is property within 200' of Saltwater Lake River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluffs > 15%
Is this permit submittal th esult of a Stop Work Notice, Correction Notice or other enforcement action?Yes
TYPE OF JOB V Add Alt Repair Other PRIMARY RESIDENCE SEASONAL ❑
Use of Building DescriUe Work
..No. of Bedrooms No. of Bathrooms .2,=, Square Footage- 1st Floor 1040 2nd Floor IO`t0
3rd Floor Basement Deck Covered Deck Other Sq. ft.
Garage�"� Attached Detached Carport Attached Detached
MANUFACTURED MNIFORMATION - Make Model YearLength WidthW, i�;rice
Vmq Bedrooms No. of Bathrooms
Type of Heat $ I Unit? Yes/No
Installer Name Cert i o.
OWNER/BUILDER Acknowledges submission of inaccurate informatiRrLmay result in alto,�Qrk order or permit revoc n
such is by signature below.I declare that I am the owner,owners legal fif t� ve,or the 6949actor.I further declare t iPAX.ivethis
permit and to do the work as proposed in the application.I declare that I have dbt'el! ermission from all the necessary pa igs.If pe�missQ.q is
required from any easement holder or any other party in interest regarding this applica io kV*proposed in the applicatimil,!wa4edbtainetf
permission from them to apply for this permit and conduct the work proposed. The owner or ageowners behalf,represents that the information
provided is accurate and grants employees of Mason County access to the above described property and structure for re�gype�U NTY
PRO M 0 I ATION F WOR1(1 BY MEANS OF A PROGRESS INSPECTIO . �1��►►11
x E Date
Owner/Owners Representative/C n (indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT Accepted by: :I Date �
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Planning Department
Environmental Health Department al �I;'' �,•.�Y'�>tC" Z.i) 2
Public Works Department
Fire Marshal
FEES
Building Permit Fee Site Inspection
Plan Review Fee EH Review Fee
Plumbing & Base Fee f 2)0 • Ob Planning Review Fee
Mechanical & Base fee O Other
Wood/Gas/Pellet Stove Fee State Fee
Violation Fee GOJP• Pre-Paid at Submittal
Valuation $ ('SZ S TOTAL FEES
MASON COUNTY PERMIT NO. ld b0(0
PLUMBING/MECHANICAL PERMIT APPLICATION
426 W. Cedar• P.O. Box 186, Shelton, WA 98584
Shelton (360)427-9670•Belfair(360)275-4467•Elma (360)482-5269
On the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFO,R_MATIQN
Ill COwner ACompany Name I y
Mailing Ad es Mailin Address
City 1v State I10 Zip Code 42b5215City State Ck-)�-1 Zip Code
Phone; Z-77-O'lq"S-) Other Ph_?M- i lU-1.33C) Phone - , Other Ph. - 704
Lien/Title Holder Contractor Reg. # 1= c
E mail address E Mail Address GILL_.
Drivers Lic. # DOB Drivers Lic.# DOB
SEPTIC INFORMATION - Connect to New Septic Existing Septic Connect to Sewer System
Name of Sewer System
PARCEL INFORMATION- 12 Digit Parcel No vio Fire District
Legal Description TS: 2-2 a: :�wI -IrC.- Z Cot,
Site Address (Please include st�reent.name, street number and city) �kY TAW VA Vi Viry 1. T'/4"tA ra_
Directions to site AL1�i1GV" 1 ,n.IIA�.V
Is property within 200' of Sal t � Lake River/Creek Pond
Wetland Seasona Stream Slopes or Bluffs > 15%
TYPE OF JOB - New VAdd Alt Repair Other Use of Building
Location of Fixtures/Units- 1st Floor �d Floor ✓ Basement Garage Closet
PLUMBING FIXTURES (Show Number of each) MECHANICAL UNIT
Type of Fixture No. f Fixtures Fees Fuel Type:Electric_LPG—Natural Gas_Heat Pump_
Toilets Type of Unit No. of Units Fees
Bathroom Sink Furnace
Bath Tubs 1 Heatpumps
Showers I Spot Vent Fan
Water Heater Propane Tank
Clothes Washer Gas Outlets
Kithen Sinks Wood/Gas/Pellet Stove
Dishwasher Kitchen Exhaust Hood
Hosebibs Dryer Vent
Other Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of
such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this
permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties. If permission is
required from any easement holder or any other parry in interest regarding this application or the work proposed in the application, I have obtained
permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information
provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection.
PROOF O Z NNUATICQF WQRK IS BY MEANS OF A PROGRESS INSPECTI N. �
X Date:TT�Eli
Owner/Owners Representative ontractor (indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by: Planning Pd Ck# Date Bld Pd Receipt No.
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Occ Group—Type Constr.
Planning Department
Environmental Health Department
FEES
Plumbing & Base Fee Site Inspection
Mechanical & Base fee UFC Plan Review Fee
Wood/Gas/Pellet Stove Fee Other
Violation Fee TOTAL FEES